Individual provider Active NPI

Steve Randle

  • Optometrist
  • Amory, MS
National Provider Identifier
1114958758
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
640715180 Issued in MS
Practice address
307 South Main St
Amory, MS 38821
Phone
(662) 256-8481
Fax
(662) 256-5276
NPI assigned
Jul 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 640715180 MS Primary
Optometrist 152W00000X MS

Addresses

Primary practice location

307 South Main St
Amory, MS 38821

Mailing address

307 South Main St
Amory, MS 38821
Phone (662) 256-8481

Other identifiers 3

IdentifierTypeStateIssuer
410002688OtherMSRAILROAD MEDICARE
00087048MedicaidMS
477949OtherMSADVANTRA FREEDOM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080716000518 MS Practitioner - Optometry 9032282520 Practice locations: Amory, MS

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

307 Main S St
Amory, MS 38821-4219
Phone (662) 256-8481

307 Main St S
Amory, MS 38821-4219

Merit-based Incentive Payment System (MIPS)

Final score
21.67 of 100Reported as individual
Quality
43.33
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114958758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 SOUTH MAIN ST",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "38821",
            "telephone_number": "662-256-8481",
            "fax_number": "662-256-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 SOUTH MAIN ST",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "38821",
            "telephone_number": "662-256-8481",
            "fax_number": "662-256-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "STEVE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "640715180",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410002688",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087048",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA FREEDOM",
            "identifier": "477949",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.